Increase In Pulse Wave Velocity Research Articles

Hippocampal volume mediates the association of arterial stiffness with cognitive impairment in adult population.

To investigate the association of arterial stiffness with brain perfusion, brain tissue volume and cognitive impairment in the general adult population. This prospective study included 1488 adult participants (age range: 22.8-83.9 years) from the Kailuan study. All participants underwent brachial-ankle pulse wave velocity (PWV) measurement, brain MRI, and Montreal Cognitive Assessment (MoCA). The association of PWV with cerebral blood flow (CBF), brain tissue volume and MoCA score was investigated. Mediation analysis was used to determine whether CBF and brain tissue volume changes mediated the associations between PWV and MoCA score. A 1 standard deviation (SD) increase in PWV was associated with lower total brain CBF [β (95% CI) -0.67 (-1.2 to -0.14)], total gray matter CBF [β (95% CI) -0.7 [-1.27 to -0.13)], frontal lobe CBF [β (95% CI) -0.59 (-1.17 to -0.01)], parietal lobe CBF [β (95% CI) -0.8 (-1.43 to -0.18)], and temporal lobe CBF [β (95% CI) -0.68 (-1.24 to -0.12)]. Negative associations were found for PWV and total brain volume [β (95% CI) -4.8 (-7.61 to -1.99)] and hippocampus volume [β (95% CI) -0.08 (-0.13 to -0.04)]. A 1 SD increase PWV was significantly associated with elevated odds of developing cognitive impairment [odds ratio (95% CI) 1.21 (1.01-1.45)]. Mediation analysis showed that hippocampal volume partially mediated the negative association between PWV and MoCA scores (proportion: 14.173%). High arterial stiffness was associated with decreased total and regional CBF, brain tissue volume, and cognitive impairment. Hippocampal volume partially mediated the effects of arterial stiffness on cognitive impairment.

Ovariectomy-Induced Arterial Stiffening Differs From Vascular Aging and Is Reversed by GPER Activation.

Arterial stiffness is a cardiovascular risk factor and dramatically increases as women transition through menopause. The current study assessed whether a mouse model of menopause increases arterial stiffness in a similar manner to aging and whether activation of the G-protein-coupled estrogen receptor could reverse stiffness. Female C57Bl/6J mice were ovariectomized at 10 weeks of age or aged to 52 weeks, and some mice were treated with G-protein-coupled estrogen receptor agonists. Ovariectomy and aging increased pulse wave velocity to a similar extent independent of changes in blood pressure. Aging increased carotid wall thickness, while ovariectomy increased material stiffness without altering vascular geometry. RNA-sequencing analysis revealed that ovariectomy downregulated smooth muscle contractile genes. The enantiomerically pure G-protein-coupled estrogen receptor agonist, LNS8801, reversed stiffness in ovariectomy mice to a greater degree than the racemic agonist G-1. In summary, ovariectomy and aging induced arterial stiffening via potentially different mechanisms. Aging was associated with inward remodeling, while ovariectomy-induced material stiffness independent of geometry and a loss of the contractile phenotype. This study enhances our understanding of the impact of estrogen loss on vascular health in a murine model and warrants further studies to examine the ability of LNS8801 to improve vascular health in menopausal women.

Assessment of arterial rigidity and daily profile of arterial pressure in women with newly detected breast cancer

Research objective: to evaluate arterial stiff ness indicators and its correlation with parameters of 24-hour ambulatory blood pressure monitoring (ABPM) in women with newly diagnosed breast cancer (BC).Material and methods: a prospective cohort study in 158 women aged 27 to 64 years with a median age of 45.4 years and newly diagnosed BC at stage IIA–IIIB before chemotherapy was conducted. The first group included 109 patients with normal or high-normal office blood pressure (BP), and the second group included 49 women with previously diagnosed stage 1– 2 essential hypertension (EH) with low or moderate cardiovascular risk. All patients underwent indirect arteriography and ABPM. Results. According to ABPM data, “masked” arterial hypertension (MAH) was diagnosed in 54 (49.5%) women in the fi rst group. In patients with MAH, the mean daily level and diastolic BP time index exceeded the corresponding indicators in EH, and the magnitude of the morning rise in systolic BP was significantly lower. In 35.4% of the examined patients with EH, the pulse wave velocity (PWV) was increased, and in 17.4% it was pathological. With MAH, these changes were recorded in 28.5% and 14.1% of cases, respectively. The odds ratio showed that in women with normal BP, the probability of an increase in PWV >10 m/s increased by 1.6 times, and in the presence of comorbidity with MAH and EH, it increased by 2.2 and 2.4 times, respectively. The risk of an increase in central systolic BP >125 mm Hg and pulse BP >60 mm Hg was highest in patients with EH.Conclusion: Among young and middle-aged women with newly diagnosed BC, a significant number of cases of MAH and EH are detected, which determines the need to evaluate arterial stiff ness and daily BP profiles before starting antitumor therapy.

An evolutionarily conserved olfactory receptor is required for sex differences in blood pressure.

Sex differences in blood pressure are well-established, with premenopausal women having lower blood pressure than men by ~10 millimeters of mercury; however, the underlying mechanisms are not fully understood. We report here that sex differences in blood pressure are absent in olfactory receptor 558 knockout (KO) mice. Olfr558 localizes to renin-positive cells in the kidney and to vascular smooth muscle cells. Female KOs exhibit increased blood pressure and increased pulse wave velocity. In contrast, male KO mice have decreased renin expression and activity, altered vascular reactivity, and decreased diastolic pressure. A rare OR51E1 (human ortholog) missense variant has a statistically significant sex interaction effect with diastolic blood pressure, increasing diastolic blood pressure in women but decreasing it in men. In summary, our findings demonstrate an evolutionarily conserved role for OLFR558/OR51E1 to mediate sex differences in blood pressure.

Increased pulse wave velocity, ventricular coupling, and cardiac remodeling

Increased pulse wave velocity, ventricular coupling, and cardiac remodeling

Pulse wave velocity on the risk stratification of aortic aneurysm

Introduction. The maintenance of tissue perfusion during the cardiac cycle is essential in organs with high metabolic demand, which is guaranteed by the maintenance of the physical properties of the arterial wall. When altered, there are hemodynamic repercussions that can be quantified using new methods, such as pulse wave velocity (PWV). These changes can occur in aortic aneurysms (AA), which have a high mortality rate associated with their rupture, making risk stratification and early intervention essential. Objectives. Demonstrate the relationship between PWV in risk stratification in patients with AA. Methods. Original articles from the Scientific Electronic Library Online (Scielo), the Latin American and Caribbean Health Sciences System (Lilacs) and PubMed Central (PMC) databases were included, which addressed the risk stratification of AA with the use of PWV in the human population. Studies published more than five years ago and those that did not address AA risk stratification based on PWV were excluded. Results and Discussion. Three articles were selected. An increase in PWV was observed in patients with abdominal aortic aneurysms (AAA) when compared to the control group (12.3 m/s x 10.9 m/s, p<0.01). Furthermore, the use of PWV is recommended in the risk stratification of all patients with AAA. Finally, the prediction of the use of PWV in the growth of thoracic aortic aneurysm (TAA) stands out, as well as its increased sensitivity for females. Conclusions. PWV is an excellent marker for cardiovascular risk stratification in AA, easy to apply clinically and at low cost. However, some issues must be resolved for its application, such as the PWV value based on age and blood pressure variables.

Association of the Single Nucleotide Polymorphisms in the Renin-Angiotensin-Aldosterone System with Hypertension in the Uzbek Population.

This research aims to identify the association between the nine polymorphic variants (rs4961, rs699, rs4762, rs5186, rs1403543, rs1799998, rs5443, rs2070744, rs1799983) and the occurrence of hypertension and its clinical manifestations in the Uzbek population. The study included 227 individuals, comprising 179 patients with hypertension and 48 controls. Clinical parameters such as age, weight, blood glucose, triglycerides, total cholesterol, low-density lipoprotein and high-density lipoprotein, blood urea nitrogen, creatinine, pulse wave velocity, left ventricular mass, and microalbuminuria levels were identified. We assessed the distribution of allele frequencies of these polymorphic variants in the Uzbek population to establish their association with cardiovascular diseases and their clinical manifestations. Genetic analysis of the polymorphic variants demonstrated a significant association of the AGT 521 C>T variant with arterial hypertension [P ≤ 0.01; Odds Ratio (OR) = 2.91]. The NOS3 -786 T>C variant correlated with left ventricular hypertrophy (P ≤ 0.05; OR = 0.35) and increased pulse wave velocity (P ≤ 0.01; OR = 0.21). The correlations of the AGTR2 1675 G>A variant with left ventricular hypertrophy (P ≤ 0.01; OR = 1.59) and increased pulse wave velocity (P ≤ 0.01; OR = 0.33) were identified. The AGT 704 T>C variant showed a significant association with increased pulse wave velocity (P ≤ 0.05; OR = 2.73). Four of the nine studied polymorphic variants were associated with clinical manifestations of hypertension in the Uzbek population. These variants can be used as genetic biomarkers to identify the risks of developing cardiovascular diseases and hypertension in the Uzbek population.

Update on the Use of Pulse Wave Velocity to Measure Age-Related Vascular Changes.

Pulse wave velocity (PWV) is an important and well-established measure of arterialstiffness that is strongly associated with aging. Age-related alterations in the elastic properties and integrity ofarterial walls can lead to cardiovascular disease. PWV measurements play an important role in the earlydetection of these changes, as well as other cardiovascular disease risk factors, such as hypertension. Thisreview provides a comprehensive summary of the current knowledge of the effects of aging on arterial stiffness,as measured by PWV. This review highlights recent findings showing the applicability of PWV analysis forinvestigating heart failure, hypertension, and other cardiovascular diseases, as well as cerebrovascular diseasesand Alzheimer's disease. It also discusses the clinical implications of utilizing PWV to monitor treatmentoutcomes, various challenges in implementing PWV assessment in clinical practice, and the development ofnew technologies, including machine learning and artificial intelligence, which may improve the usefulness ofPWV measurements in the future. Measuring arterial stiffness through PWV remains an important technique to study aging, especiallyas the technology continues to evolve. There is a clear need to leverage PWV to identify interventions thatmitigate age-related increases in PWV, potentially improving CVD outcomes and promoting healthy vascularaging.

Chronic kidney disease is associated with cognitive dysfunction and cardiovascular remodeling in aged male and female Sprague‐Dawley rats

AbstractBackgroundCardiovascular diseases (CVD), including increased central arterial stiffness (CAS), accompany chronic kidney disease (CKD) development. An increase in pulse wave velocity (PWV), an index for CAS, is implicated in age‐associated changes in the brain and potentiates the development of CI in CVD and CKD in humans and animal models. The aim of this study was to determine whether inducing CKD accelerates the development of CI and CAS in aged male and female rats.MethodTen months‐old male and female Sprague‐Dawley rats were fed with 0.25% adenine diet to accelerate CKD (n = 10‐12; CKD‐male, CKD‐female) or regular diet (n = 8‐10; CNT‐male, CNT‐female) for 8weeks. Body weight (BW), blood pressure (BP), heart rate (HR), aortic‐PWV (aPWV), behavioral tests, blood urea nitrogen (BUN), creatinine and hematocrit were assessed at the endpoint. The anxiety‐like behavior was tested in open field test (OFT) and elevated plus maze (EPM). Morris water maze (MWM) and cross maze (CM) were used to test spatial memory. The data were analyzed using two‐way ANOVA.ResultCKD development in both sexes was accompanied by kidneys enlargement, increase in BUN and creatinine, and reduction in hematocrit. In CKD‐male the kidney function was more compromised with higher levels of BUN and creatinine vs. CKD‐female (Table 1). CKD‐male had lower BW and SBP vs. CNT‐male (Table 1). CKD induced a reduction in HR, increase in aPWV and aortic weight in both sexes vs. respective CNT‐groups (Figure 1). Both CKD‐male and CKD‐female demonstrated a tendency of increase in path length to find the hidden platform in MWM, e.g., both sexes had numerically impaired spatial memory. CKD‐male spent less time in the center of OFT, a measure of anxiety, and loss of spatial memory, with a reduction of spontaneous alternation task assessed by CM. CKD‐female exhibited higher level of anxiety spending less time in open arm of EPM vs. CNT‐female (Figure 2).ConclusionCKD development in old male and female Sprague‐Dawley rats was accompanied by an increase in CAS, cardiovascular remodeling, and cognitive dysfunction. In CKD, CI affected different cognitive domains in the old males than in the age‐matched females.Supported by NIA/NIH/IRP

Abstract 13220: Independent Effects of Baseline Pulse Wave Velocity versus Advancing Age on Changes in Arterial Stiffness Over Time

Introduction: While arterial stiffness (AS) is a known marker of vascular ageing that prognosticates cardiovascular disease (CVD), prospective analyses of AS evolution alongside chronological age are necessary to understand factors that drive progressive AS. Using pulse wave velocity (PWV) we investigated the impact of baseline factors in predicting PWV changes over a 5-year period. Hypothesis: We hypothesized that certain baseline factors in older Asian adults are predictive of PWV trajectories later in life independent of chronological age. Methods: Participants without CVD from a community-based cohort had their clinical risk factors collected prospectively, and PWV (m/s) measured using a cuff-based oscillometric pulse wave analysis machine at baseline and 5-year timepoint. Results: This analysis included 159 participants (41.5% women, mean age 67.7 ± 10.2 years). ΔPWV (2.19 ± 2.25), the 5-year change in PWV, was associated with baseline PWV (β = -0.687, p < 0.001), age (β = 0.084, p < 0.001), hypertension (β=0.763, p = 0.033), weight (β = -0.042, p = 0.018) and waist circumference (β = -0.045, p = 0.018). Gender, body mass index, dyslipidemia, diabetes mellitus and lifetime smoking status were not significantly associated with ΔPWV. ΔPWV was independently associated with baseline PWV (β = -1.17, 95% CI -1.65 - -0.70, p < 0.001) and age (β = 0.144, 95% CI 0.09 - 0.20, p < 0.001) adjusting for weight, waist circumference and hypertension, with insignificant interaction between baseline PWV and age (p = 0.431). Participants with increases in PWV after 5 years, compared to those without PWV increase, had lower PWV (8.52 ± 1.81 vs 11.10 ± 2.44) at baseline. Conclusions: Baseline PWV was associated with changes in AS over a 5-year period independent of age and clinical risk factors. The inverse relationship between baseline PWV and ΔPWV may suggest plateauing of PWV increases at higher baseline PWV levels. In addition, high baseline PWV may not predict worsening of AS later in life.

Study of indicators of arterial stiffness in young people depending on ‘classical’ and ‘modern’ risk factors

Objective. To identify ‘classical’ and ‘modern’ risk factors (RFs) in young people aged 18–25 years in a student environment and evaluate their impact on arterial wall stiffness using non-invasive examination methods.Materials and methods. 171 students of a humanitarian university aged 18–25 years old were examined, of which 52.1 % were girls and 47.9 % were boys. An anonymous survey was conducted to identify the main risk factors. The method of volumetric sphygmography and highly sensitive compression oscillometry was used to assess the state of the vascular wall.Results. Against the background of ‘classic’ risk factors (low physical activity – 61.9 %, essential arterial hypertension [AH] – 29.8 %, aggravated heredity for hypertension – 18.3 %, overweight – 14.0 %, obesity – 8.5 %, cigarette smoking – 3.0 %), ‘modern’ RFs were identified: a combination of hookah and cigarette smoking – 31.0 %, use of electronic cigarettes – 17.0 %, use of energy drinks – 25.3 %. In students with the presence of ‘modern’ PR, the values of pulse wave velocity (PWV) were obtained – 8.4 ± 2.7 m/s, relative to the PWV of students without PR 5.1 ± 0.6 m/s (p = 0.002). It was found that the relative risk of an increase in PWV with the combined use of hookah and cigarettes increases by 52.1 times (95 % CI: 11.2–242.1 at χ2 = 37.987; p = 0.001), with the use of energy drinks by 27.4 times (95 % CI: 6.8–111.0 at χ2 = 29.328; p = 0.001), when using electronic cigarettes by 2.6 times (95 % CI: 1.3–5.2 at χ2 = 6.496; p = 0.011).Conclusions. Students aged 18–25 years showed a high adherence to modern risk factors (a combination of hookah and cigarette smoking, energy drinks, use of electronic cigarettes) that lead to a violation of the elastic properties of the vascular wall, which indicates endothelial dysfunction.

Photoplethysmography factors associated with undiagnosed hypertension in men with low and moderate cardiovascular risk

Aim. To study the functional state of the terminal arteries and arterioles of the skin using photoplethysmography (PPG) in men with hypertension (HTN) of low and moderate cardiovascular risk (CVR) and to identify morphofunctional diagnostic criteria associated with HTN.Material and methods. A total of 118 healthy men (30-60 years old) underwent clinical and biochemical blood tests, PPG, ultrasound of cardiac and main arteries, 24-hour blood pressure monitoring. According to 24-hour blood pressure monitoring, two groups were formed: the control group — 59 normotensive men, HTN group — 59 men with HTN.Results. According to the PPG data, men with HN had higher normalized augmentation index (Alp75) (3,8 and -5,25%; (p<0,005)), stiffness index (SI) (7,6 and 7,35 m/s) (p<0,05) and reflection index (RI) (36,5 and 28,4%) (p<0,005), respectively. According to multivariate analysis, an increase in RI ≥30,6% (odds ratio, 4,6; p=0,0476) and SI ≥7,9 m/s (odds ratio, 3,69; p=0,019) was significantly associated with HTN. A regression model has been developed that includes age ≥35 years, RI ≥30,6% and SI ≥7,9 m/s, which allows predicting HTN in men with low and moderate cardiovascular risk with a sensitivity of 78% and a specificity of 62,1%.Conclusion. Men with HTN of low and moderate CVR are characterized by an increase in vascular stiffness, tone of smooth muscle cells, terminal muscular arteries and arterioles, and an increase in pulse wave velocity. The developed model can be used to predict hypertension in these patients and determine indications for further examination.

Abstract P127: Protective Effects Of Protocatechuic Acid In Murine Model Of UUO-induced Renal Injury

Chronic kidney disease (CKD) is a global public health problem, affecting millions of people worldwide. CKD can result from obstructive nephropathy; a condition that arises from urinary flow obstruction in the kidneys, leading to renal inflammation and injury. Protocatechuic acid (PCA) is a natural phenolic compound that showed a promising protective effect in cardiovascular diseases. In the current study, we investigated the reno-protective effects of PCA in mice model of unilateral ureteral obstruction (UUO). Male C57BL/6J mice (10-12 weeks old) were divided into 4 groups (n=6-8/group). Sham control, Sham/P (sham plus PCA (50 mg/kg IP daily for two weeks), UUO, and UUO plus PCA. Induction of UUO significantly decreased creatinine clearance (CrCl) and increased pulse wave velocity (PWV), a marker of arterial stiffness, relative to sham control (CrCl; sham control: 60.6 ± 14 vs. UUO: 24.5 ± 6.0 ml/day and PWV; sham control: 1.58 ± 0.1 vs. UUO: 3.35 ± 0.22 m/s). Immuno-histochemical analysis revealed that KIM-1 expression, a marker of tubular injury, was elevated in UUO mice vs. sham control and PCA reduced this elevation, however there was no significance difference in urinary KIM-1 excretion. Moreover, UUO significantly increased renal oxidative stress and inflammation as evidenced by elevation in renal TBARs, IL-6, active caspase-1 and active MMP2 compared to sham control (TBARs; sham control: 8.3 ± 0.9 vs. UUO: 30.5 ± 3.33 nmol/mg protein, renal IL-6; sham control: 1 ± 0.07 vs. UUO: 24.35 ± 8.55 pg/mg protein, active caspase-1; sham control: 1.7 x 10 3 ± 95 vs. UUO: 2.79 x 10 3 ± 145 cpm/μg protein and MMP2; sham control: 1.6 ± 0.4 vs. UUO: 6 ± 0.6 ng/μg protein). PCA treatment significantly improved the UUO-induced decline in creatinine clearance (52.5 ± 10.2 ml/day) and attenuated UUO-induced elevation in renal PWV (1.95 ± 0.1 m/s). Furthermore, PCA treatment significantly decreased renal TBARs (5.2 ± 1.12 nmol/mg protein), IL-6 (5.39 ± 1.4 pg/mg protein) and active MMP2 (1.1 ± 0.3 ng/μg protein) in UUO-induced renal injury. Collectively, these data suggests that PCA provides renal protection in murine model of UUO via reduction of renal oxidative stress, inflammation and fibrosis.

Central blood pressure obtained by cuff-based oscillometry as a determinant of left ventricular hypertrophy in hypertensive patients.

Limited and conflicting data have been reported on the prognostic relevance of central blood pressure (CBP) compared with brachial blood pressure (BP) in the anticipation of hypertension-mediated organ damage and the majority of data derived using applanation tonometry with its known complexities. The objective of the present study was to investigate the diagnostic factors of left ventricular hypertrophy (LVH) with a special highlight on the utility of non-invasive oscillometric CBP measurement and derived hemodynamic indices compared to brachial BP as indicators of LVH. This cross-sectional study included 300 hypertensive patients (mean age 55.3 years, 61.3% female, 51.7% obese) with a mean duration of hypertension was 5.8 years. They underwent measurement of brachial BP, using a mercury sphygmomanometer, and CBP, using a Mobil-O-Graph, alongside the determination of left ventricular (LV) mass by two-dimensional transthoracic echocardiography. LVH and LV geometric patterns were defined by LV mass index/height 2.7 and relative wall thickness. Bivariate then multivariate analysis showed that age, BMI, central systolic BP (SBP), and pulse wave velocity (PWV) were significant determinants of LVH and optimally controlled brachial BP was a significant negative determinant for LVH. Central SBP had an acceptable diagnostic performance to determine LVH in patients with hypertension (AUC = 0.722, 95% confidence interval: 0.618-0.824, SE = 0.21, P -value <0.001). Using one-way ANOVA, a comparison of means among age groups showed that the steady increase in central SBP and PWV with aging was greater among LVH patients than non-LVH patients. Estimated central SBP using Mobil-O-Graph showed a significantly higher correlation to LVH than brachial SBP values. The consistent increase in central SBP and PWV with aging was greater among LVH patients than non-LVH patients.

Impact of Disulfide/Thiol Redox Couple on Pulse Wave Velocity in Patients with Normal Coronary Angiography

Introduction: The oxidized thiol/disulfide couple has been investigated and reported as a potential risk factor for cardiovascular diseases. Additionally, an increased pulse wave velocity has been identified as a predictor of cardiovascular events. Patients and Methods: 262 patients were included in our study. Native and total thiol levels, total disulfide levels, disulfide per total thiol ratios, native thiol per total thiol ratios, and disulfide per native thiol level ratios were calculated. Results: Patients were divided into Pulse Wave Velocity (PWV) low and PWV high groups. Native and total thiol levels were higher in PWV low group compared to PWV high group (p&lt; 0.001 for both). The median disulfide value was higher in PWV high group (p= 0.002). Disulfide per native thiol and disulfide per total thiol ratio values were higher in PWV high group (p&lt; 0.001). Native thiol per total thiol ratios were higher in the PWV-low group (p&lt; 0.001). Conclusion: The disulfide/native thiol pathway may be an indicator for predicting future atherosclerotic cardiovascular events.

Effects of intravenous sodium thiosulfate on vascular calcification in dialysis patients with end-stage renal disease: a systematic review and meta-analysis.

In dialysis patients, vascular calcification is a common complication and is closely related to the morbidity and mortality of cardiovascular disease. We performed a systematic review to determine the efficacy and safety of sodium thiosulfate (STS) in the progression of vascular calcification in dialysis patients with end-stage renal disease. The PubMed, Web of Science, Embase, Cochrane Library, Wanfang, CNKI, China Biology Medicine disc and Weipu databases were searched up to 9 March 2022 for clinical trials to synthesise findings on the efficacy and safety of STS in the progression of vascular calcification in dialysis patients. The primary outcome was coronary artery calcification scores (CACS) or abdominal aortic calcification scores (AACS) or Kauppila index. The secondary outcome was pulse-wave velocity (PWV). Laboratory data were shown in safety data. A random-effect model was used to provide the summary measures of effect [standardised mean difference (SMD) and 95% confidence interval (CI)]. Seven randomised, controlled trials and one nonrandomised, controlled trial involving 370 patients were included. Six studies reported that the progression of CACS or AACS was slower in the intravenous STS group compared with the control group (SMD -3.24, 95% CI: -5.29, -1.18, p = 0.002). Two studies showed the increase in PWV was less in the STS group compared with the control group (SMD -0.52, 95% CI: -0.92, -0.13, p = 0.009). During the trial period, a lower high-sensitivity C-reactive protein level (SMD 1.61, 95% CI: 0.19, 3.04, p = 0.03), a decrease in serum bicarbonate level (SMD 0.67, 95% CI: 0.22, 1.11, p = 0.003) and an increase in serum phosphate level (SMD -0.32, 95% CI: -0.62, -0.03, p = 0.03) were noted in the intravenous STS group compared with the control group. However, serum calcium and parathyroid hormone levels showed no difference between the two groups after the trials. The most common adverse events were temporary nausea and vomiting, which occurred in 12.5 to 75% of patients. Intravenous STS may slow down the progression of vascular calcification and ameliorate arterial stiffness in dialysis patients. Reliably defining the efficacy and safety of intravenous STS in attenuating the progression of vascular calcification requires a high-quality trial with a large sample size.

Transition patterns of metabolic dysfunction-associated fatty liver disease status in relation to arterial stiffness progression: a health check-up cohort study

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new diagnostic criterion based on hepatic steatosis and metabolic dysfunction. However, a comprehensive evaluation of the association of MAFLD dynamic transitions with arterial stiffness progression has yet to be conducted. This cohort study included 8807 Chinese health check-up participants (median follow-up = 50.2 months). Participants were categorized into four groups according to MAFLD status at baseline and follow-up (none, persistent, developed and regressed). Arterial stiffness progression was assessed by the annual brachial-ankle pulse wave velocity (ba-PWV) increase and arterial stiffness incidence. Compared with the non-MAFLD group, the annual increase in ba-PWV was highest in the persistent-MAFLD group [6.75 cm/s/year, (95% CI 4.03–9.33)], followed by the developed—[6.35 cm/s/year, (95% CI 3.80–8.91)] and the regressed—[1.27 cm/s/year, (95% CI − 2.18 to 4.72)] MAFLD groups. Similarly, compared with the non-MAFLD group, the persistent-MAFLD group had a 1.31-fold increased arterial stiffness risk [OR 1.31; 95% CI 1.03–1.66]. The associations of MAFLD transition patterns with arterial stiffness incidence did not differ across any clinically specific subgroups evaluated. Furthermore, the potential effect of dynamic changes in cardiometabolic risk factors on arterial stiffness incidence among persistent-MAFLD participants was mostly driven by annual fasting glucose and triglyceride increases. In conclusion, persistent MAFLD was associated with an increased risk of arterial stiffness development. Moreover, in persistent-MAFLD subjects, elevated blood glucose and triglyceride levels might facilitate the arterial stiffness incidence.

#2599 LONG-TERM LONGITUDINAL CHANGES OF PULSE WAVE VELOCITY AND THEIR ASSOCIATION TO CARDIOVASCULAR RISK FACTORS IN MAINTENANCE HEMODIALYSIS PATIENTS

Abstract Background and Aims The incidence of end-stage renal disease (ESRD) is increasing worldwide. The mortality rate in this patient cohort remains unacceptably high. The WHO estimates ESRD as one of the ten global causes of premature death. Approximately half of all death cases are due to cardiovascular complications. A main cardiovascular risk factor is enhanced arterial stiffness. The measurement of pulse wave velocity (PWV) for evaluation of progressive atherosclerosis is known to be an independent risk predictor for cardiovascular and all-cause mortality in chronic dialysis patients. Method The study cohort contains patients from the “Risk stratification in end-stage renal disease - the ISAR study”, a multicenter prospective longitudinal observatory cohort study. A total of 105 patients on maintenance hemodialysis were examined and followed-up for up to 72 months. Pulse wave velocity was obtained by the Mobil-O-Graph 24h PWA Monitor device at baseline and follow-up. We assessed the PWV change over time and correlated PWV with known cardiovascular risk factors using Pearson correlation coefficient adjusting for age. Longitudinal changes were examined using t-tests for paired and independent samples. Results Patients had a median age of 61,2 years (IQR 23,2), 36 (34%) were female. Median baseline dialysis vintage was 105 months (IQR 71), and median adapted Charlson Comorbidity Index 2 (IQR 3). During a median follow-up of 74,1 months there was a significant increase in PWV from baseline (9,25 m/s) to 6YFU (10,18 m/s, p = &amp;lt;0,001), a delta-PWV of 0,92 m/s, appropriate to a yearly change of 0,15 m/s. Patients with hypertension had a significant higher PWV (10,47 m/s) than those with normal blood pressure (8,91 m/s, p = 0,034). The Pearson correlation coefficient analysis showed after adjustment for age a significant correlation between blood pressure and both 6YFU-PWV (systolic r = 0,89 diastolic r = 0,62, p = &amp;lt;0,001) and delta-PWV (systolic r = 0,71 diastolic 0,48, p = &amp;lt;0,001). Additionally, after adjustment for age delta-PWV correlated with LDL-cholesterol (r = 0,27, p = 0,023). Neither 6YFU-PWV nor delta-PWV showed significant associations to other traditional cardiovascular risk factors such as diabetes, high cholesterol or obesity. Conclusion In this cohort, we found a longitudinal increase of pulse wave velocity over 6 years. However, the average change in PWV per year was significantly lower in our cohort compared to other studies with a shorter observation period. A main reason might be the long follow-up time, with the occurrence of several deaths in the primary cohort of the ISAR-Study before reaching the follow-up point and therefore including more younger and possibly healthier patients. Nevertheless, in this cohort blood pressure in contrast to diabetes, high cholesterol or obesity was a primary factor in the change of PWV. The reasons for the deceleration of cardiovascular and mortality risk after a long term in this sub cohort remains unclear and requires further investigation.

#3829 ARTERIAL STIFFNESS AND METABOLIC SYNDROME INDICES IN RENAL TRANSPLANTATION PATIENTS

Abstract Background and Aims Although renal transplantation improves survival, cardiovascular morbidity and mortality still remain as a significant problem compared with nonrenal populations. In end stage renal disease metabolic cardiovascular risk factors such as hypertension, hyperuricemia, obesity and diabetes mellitus have been confirmed to be positively correlated with arterial stiffness. Arterial stiffness is an important characteristic of the arterial wall and can be assessed noninvasively by the measurement of carotid-femoral pulse wave velocity (PWv). The aim of this study is to evaluate the risk factors for arterial stiffness in kidney transplant recipients. Method One hundred and forty nine kidney transplant recipients from our renal transplant outpatient clinic were enrolled into the study. All patients were evaluated for their standard clinical (age, gender, duration of hemodialysis, post-transplant time), biochemical parameters. Anthropometric and body composition analyses were performed for all patients. Body compositions were analyzed by using the Body Composition Analyzer (Tanita BC- 420MA). PWv was determined from pressure tracing over carotid and femoral arteries using the SphygmoCor system. Results Patients were divided into two groups according to PWv levels. The frequency of patients with PWv ≥ 7 m/s was higher in patients with new onset diabetes (55.9%), hyperuricemia (uric acid level type="Periodical" type="Periodical" type="Periodical" type="Periodical" type="Periodical" type="Periodical" type="Periodical" type="Periodical"&amp;gt; 7 mg/dl) (p:0.029, 0.05). Higher carotid-femoral PWv was significantly related with systolic (p:0.003) and diastolic blood pressure (p:0.002), uric acid (p:0.0001) and fasting glucose (p: 0.02) levels. According to body composition analyses, muscle mass, visceral fat ratio and body weight were significantly higher in patients with PWv ≥ 7 m/s (p &amp;lt; 0.005). In patients with high PWv, sagittal abdominal diameters and waist circumferences were significantly higher than patients with PWv &amp;lt; 7 m/s. When criteria for metabolic syndrome were assessed there were a significant increase in pulse wave velocity in patients with 0-1; 2-3; and 4-5criteria (p &amp;lt; 0.01). Conclusion In post transplantation period, metabolic syndrome indices as high blood pressure, hyperuricemia, hyperglycemia and increased waist and hip circumferences are closely related with arterial stiffness. For cardiovascular risk reduction after renal transplantation; blood pressure, serum glucose and uric acid levels should be under strict control.

#4063 APELIN INCREASES FOREARM BLOOD FLOW IN CHRONIC KIDNEY DISEASE

Abstract Background and Aims Chronic kidney disease (CKD) affects 1 in 10 people and cardiovascular disease is its commonest complication. Despite current standard of care, many patients continue to progress to kidney failure and/or die of cardiovascular disease. Thus, there is an urgent unmet need for new treatments that slow kidney function decline and offer broad cardiovascular protection. The apelin system, comprising the apelin receptor and its two endogenous ligands apelin and elabela, is an attractive therapeutic target for CKD. Apelin is an endothelium-dependent vasodilator and a potent inotrope. Clinical studies show that apelin improves endothelial function in health and heart failure, and pre-clinical studies in models of kidney disease find apelin offers renoprotection. At present, apelin has not been studied in patients with CKD. The aims of this study were to examine the local vascular actions of apelin in CKD. Method Participants with stable, non-diabetic CKD and age- and sex-matched healthy volunteers were recruited to a prospective, randomised, placebo-controlled study. Blood pressure and arterial stiffness (measured using pulse wave velocity) were assessed at baseline. Endothelial function was examined using gold-standard venous occlusion plethysmography. Forearm vasodilatation was measured in response to incremental intra-arterial doses of acetylcholine (7.5, 15 and 30 μg/min, used to assess endothelium-dependent vasodilatation), sodium nitroprusside (1, 2 and 4 μg/min, used to assess endothelium-independent vasodilatation), and pyroglutamated apelin-13 ([Pyr1]apelin-13; 0.3, 1, 3, 10, 30 and 100 nmol/min). Circulating tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) were assessed as measures of endogenous fibrinolysis. Results Fifteen patients with CKD (mean age 55±4 years; 53% male) and 15 healthy volunteers (mean age 51±3 years; 67% male) completed the study. In comparison to healthy volunteers, patients with CKD had a higher blood pressure (mean arterial pressure: 102 mmHg versus 93 mmHg, p&amp;lt;0.05) and increased pulse wave velocity (7.5±2.2 m/s versus 6.0±0.9 m/s, p&amp;lt;0.01). Similar dose-dependent vasodilatation to acetylcholine and sodium nitroprusside was seen in both groups. [Pyr1]apelin-13 increased forearm blood flow by a maximum of ∼30% in both health and CKD (p&amp;lt;0.01 compared to baseline for both) (Figure 1). This response appeared to be dose-dependent. Net tPA antigen release increased 20-70 fold in response to [Pyr1]apelin-13 in both health and CKD, with a trend to a greater release in CKD. There was no change in PAI-1. No relationship was seen between the response to [Pyr1]apelin-13 and kidney function. Conclusion Apelin promotes vasodilatation in optimally managed patients with CKD and may regulate endogenous fibrinolysis. If this effect were maintained in the long-term with systemic apelin treatment, it would be expected to reduce cardiovascular risk. Systemic studies are now justified to investigate the haemodynamic and renal effects of apelin in these patients.